Class 13

Hostile Personality

Adjustment to Threatening Events

Announcements:

Midterm Review: Thursday

Midterm: Tuesday, March 11

Hostile Personality

Hostility as a Health ThreatSelye: A person confronted with major stressor goes into one of two modes: Fight FlightOR

Anxious, pessimistic, low efficacy will tend to which response? Flight

Imagine someone in chronic “fight” mode, always ready for attack or defense

How would he/she perceive situations? Interpret other people?

More threatening, as self-serving, un-trustworthy, dog-eat-dog world

How would this person behave toward others?

Socially abrasive, smaller social network, avoid others when in need

Hostility is considered to be an attitudinal set—perhaps a personality trait—which stems from an absence of trust in the basic goodness of others and centers around the belief that others are generally mean, selfish, and undependable.

Williams, Barefoot, & Shekelle, 1985

Hostility Defined

http://www.youtube.com/watch?v=78b67l_yxUc

Case Study of Hostile Personality

YES NO

1 No one cares much what happens to you

2 I have often met people who were supposed to be experts who were no better than I.

3 Some of my family have habits that bother and annoy me very much.

4 I often have to take orders from someone who did not know as much as I did.

5 It makes me feel like a failure when I hear of the success of someone I know well.

6 People often disappoint me.

7 It is safer to trust nobody.

8 I have often felt that strangers were looking at me critically.

9 I tend to be on my guard with people who are somewhat more friendly than I expected.

10 My way of doing things is apt to be misunderstood by others.

Hostility Scale(Cook and Medley, 1954)

1. Hostile

2. Competitive

3. Work-a-holic

4. time-pressed

Qualities of Type A Personality

Which component the most important?

X

Blockage of blood vessels

Coronary Heart Disease (CHD) (1.5 time greater odds)

20-year increased risk of death due to:

* CHD* Malignant Neoplasms (cancer)* All causes of death combined

Health Correlates of Hostility

Is Relation Between Hostility and Heart Disease Linear or Catastrophic?

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None VeryLittle

Little Moderate Mod Plus A Lot A GreatDegree

Hostility Score

Hea

rt D

isea

se

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None VeryLittle

Little Moderate Mod Plus A Lot A GreatDegree

Hostility Score

Hea

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Linear Catastrophic

-1

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0 TO 8 9 TO 13 14 TO 17 18 TO 31

Hostility Score

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Hostility and Coronary Heart Disease Among MDsBarefoot, et al., 1983

0.85

0.87

0.89

0.91

0.93

0.95

0.97

0.99

1960- 1965- 1970- 1975- 1980-

Pe

rce

nt

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rviv

ing

Low HostileHigh Hostile

MD Survival Rates Over 25 Years:Low Hostile vs. High Hostile

How Is the Hostile Personality Formed

Ken Dodge Research on Hostile Children

Parental disciplinary style:1. Punishment is severe, often disproportionate to offense2. Punishment is not accompanied by explanation

Sibling bullying: Learn to read hostile signals quickly, and respond quickly.

Hostile attributional style: 1. Regard ambiguous negative events as intentionally hostile

2. Believe it is essential to retaliate quickly

Appraisal of threat higher defensive mode (fight)

more cardiac output ↑ cortisol atherosclerosis

Pathway From Hostility to Heart Disease

What seems to be common physio culprit in link between stress, depression, hostility and health risks?

Cortisol

Adjusting to Threatening Events

Misfortune: Bad and Badder

___A. Person poisoned by meds that oddly conflict with her chemistry

___B. Person poisoned by meds her MD is using to test his new theory.

WHO IS MORE DISTURBED:

___A. Person who’s child gets cancer due to second-hand smoke in home

___B. Person who’s child gets cancer due to heredity

X

X

X

___A. Train passenger injured b/c of failed train brakes

___B. Train passenger injured, but cause of crash never determined

Fundamental Beliefs

1. World is just.

2. World is sane, well ordered, non-random

3. The self is good

Traumas: Events that seriously violate one or more of these beliefs.

Fundamental Beliefs and Misfortune

___A. Person poisoned by meds that oddly conflict with her chemistry

___B. Person poisoned by meds her MD is using to test his theory.

Which belief has been violated:

The Self is Good, The World is Well Ordered, The World is Just

___A. Train passenger injured b/c of failed brakes

___B. Train passenger injured, but cause of crash never determined

___A. Person who’s child gets cancer due to second-hand smoke in home

___B. Person who’s child gets cancer due to heredity

X

X

X

The self is good

The world is orderly, not random

The world is just

Strategies for Overcoming Threatening Events

1. Achieve a sense of meaning out of the event.

2. Regain mastery over the event, or over life in general

3. Enhance self-esteem

How People Restore Sense of Meaning Following Trauma

1. Seek out causes of event.

2. Re-adjust way of seeing life, and themselves.

Victor Frankl

Taylor Article: Adjusting to Threatening Events

Meaning is key to coping. But what about bad situations where there is no clear cause?

Subjects in Taylor article are: _______________________women with breast cancer

Is cause of breast cancer (on individual level) known? ____

Do women with breast cancer typically accept that there is no single, diagnosable cause? ____

Why is this?

No

No

Self-Identified Causes of Breast Cancer Taylor, et al., 1983

a. Stress, esp. relationship 41%

b. Carcinogen 32%

c. Hereditary 26%

d. Diet 17%

e. Freak event 10%

Note: Some women listed multiple causes, thus total more than 100%

Adopting New Meanings About Life

a. New attitude toward life

I feel as if I were for the first time really conscious.I have much more enjoyment each day, each moment. All those things you get entangled with don’t seem to be part of my life right now.

b. Self knowledge

It’s a bit like holding up a mirror to one’s face when one can’t turn around.

Patients’ Responses to Their Cancer

Change diet

Quit meds. maybe associated with cancer

Educate self on cancer

Control side effects:* Imaging: Chemo as cannons* Instruction to body: "Cut this shit out“

Not clear any of these responses actually cure cancer—why do them?

Bad Events Threaten Self Esteem

When people suffer bad events, they feel bad about selves, even if they are not responsible. Why?

Just world beliefs: Good things happen to good people, bad things happen to bad people. Therefore...

People very good at finding way to restore sense of self worth. Cancer patients do so even after disfiguring surgery, painful treatment, constant threat of cancer recurrence. How do they do it?

Woman who underwent lumpectomy

I had a comparatively small amount of surgery. How awful it must be for women who have had a mastectomy. I just can’t imagine, it would seem so difficult.

Woman who had a mastectomy

It was not tragic. It worked out okay. Now if the thing had spread all over, I would have had a whole different story for you.

An older woman

The people I really feel sorry for are these younger gals. To lose a breast when you’re so young must be awful. I’m 73; what do I need a breast for?

A young woman (apparently having lost a breast)

If I hadn’t been married, I think this thing would have really gotten to me. I can’t imagine dating or whatever knowing you have this thing and not knowing how to tell the man about it.

Downward Social Comparison Among Breast Cancer Patients

Methods

1. Downward social comparison2. Unsupported causal explanations

* Cancer due to diet* “Cells have re-aligned. Now I'm safe.”* Can stop cancer via imaging, positive thinking

3. Denial

Benefits?1. Enhance control2. Enhance self-worth3. Enhance persistence4. Encourage coping behaviors

Nature and Benefits of Illusions

"Undoing": The Toxic Aspect of Illusions of Control

Two Olympic sprinters lose in finals; one comes in second to last, the other second to first. Who has done better? Who feels worse? Why?

Undoing: AKA "counterfactuals"--the mental process of thinking how negative outcomes could have been prevented.

Parents of Sudden Infant Death Syndrome (SIDS) infants (Davis, Silver, et al., PSPB, 1995).

Undoing related to: SCL, Guilt, Anger, Depression, Anxiety 18 mos later

"I thought about maybe if I'd stayed awake, or woke up more frequently [to] check on the baby. I keep thinking of different ways..."

Coping = Illusions?

Is coping all about self-serving "spin"?

Is avoiding reality the best way to cope with uncontrollable negative events?

Kriegel: "Falling into Life"

Every time I was removed from the hot water and placed on a stretcher by the side of the pool, ... , I was fed salt tablets. Even today, more than four decades later, I shiver at the mere thought of those salt tablets. ...To be an eater of salt was far more humiliating than to endure pain. ...we dreaded eating salt. It was that, rather than the pain we endured, that anchored our sense of loss and dread.

Kriegel: "Falling into Life"

MEANINGWhat aspect of trauma does this passage reflect?

I suppose we have been told that our fall from grace was permanent. But I am still grateful that no one—told me that my chances of regaining the use of my legs were nonexistent. At the age of 11 I needed to weather reality, not face it.

Kriegel: "Falling into Life"

DENIALWhat aspect of trauma does this passage reflect?

1. I hungered for the approval of those in authority.

Kriegel: "Falling into Life"

1. Self-Esteem

2. Just World

What aspects of trauma do these passage reflect?

2. I wanted to do whatever was supposed to be "good" for me. I believed absolutely as I have ever believed in anything that rehabilitation would finally placate the hunger of the virus.

Kriegel: "Falling into Life"

As my "normal" past grew more and more distant, I reached out for it more and more desperately.

Why?

And then, terror simply evaporated. It was as if I had served enough time in that prison. "That's it" my therapist triumphantly shouted. "You let go! and there it is!" Yes, and you discover not terror but the only self you are going to be allowed to claim anyhow. You fall free, and then you learn that those padded mats hold not courage but the unclaimed self.

What has happened here? What’s changed? What is the “prison”? What is the “unclaimed self”?

Kriegel: "Falling into Life"

To create an independent self, a man had to rid himself of both the myths that nurtured him and the myths that held him back. ... I understood that the most dangerous threat to the sense of self I needed was an inflated belief in my own capacity.

What does Kriegel mean by “myths”?

What was the “sense of self [he] needed”?

Why was inflated belief “the most dangerous threat” to that sense of self?